highly significantp < 0.001
(3) Consistency between C-DOS and C-ONI The two tools demonstrated a highly significant statistical association in binary classification [χ 2 (1) = 200, p < 0.001; OR = 42.8, 95% CI: 20.3–90.2]; however, their agreement was only moderate [κ = 0.50], with 65 cases (9.4%) being classified discordantly.